S L Orebaugh1, P E Bigeleisen, M L Kentor. 1. Department of Anesthesiology, UPMC-Southside Anesthesia, Pittsburgh, PA 15203, USA. orebaughsl@anes.upmc.edu
Abstract
OBJECTIVE: The specific aim of this study was to determine the ability of anesthesiology residents to independently identify a series of anatomic structures in a live model using ultrasound, both before and after a 4-week regional anesthesia rotation that incorporates a standardized ultrasound training curriculum for peripheral nerve blockade. METHODS: Ten CA2 and CA3 anesthesiology residents volunteered to participate in this study. Each resident was subjected to a pre-rotation practical exam, in which he attempted to identify 15 structures at four sites of peripheral nerve blockade, in a test subject. Each resident then received specific training for ultrasound-guided nerve blocks during a 4-week regional anesthesia rotation, and then completed a post-rotation exam. The mean number of structures correctly identified on the exams was compared for significant differences utilizing a paired t-test. RESULTS: Residents were able to identify significantly more anatomic structures on the post-rotation exam as compared with the pre-rotation exam (mean 14.1 vs. 9.9, P<.001), as well as more peripheral nerve targets. The most frequently misidentified structures on the pre-rotation exam were the subclavian vein, the sciatic nerve in the popliteal fossa, and the femur. CONCLUSIONS: Ultrasound-naive anesthesiology residents, who received instruction and experience with ultrasound-guided peripheral nerve blocks on a 4-week regional anesthesia rotation, significantly improved their ability to independently identify relevant anatomic structures with ultrasonography.
OBJECTIVE: The specific aim of this study was to determine the ability of anesthesiology residents to independently identify a series of anatomic structures in a live model using ultrasound, both before and after a 4-week regional anesthesia rotation that incorporates a standardized ultrasound training curriculum for peripheral nerve blockade. METHODS: Ten CA2 and CA3 anesthesiology residents volunteered to participate in this study. Each resident was subjected to a pre-rotation practical exam, in which he attempted to identify 15 structures at four sites of peripheral nerve blockade, in a test subject. Each resident then received specific training for ultrasound-guided nerve blocks during a 4-week regional anesthesia rotation, and then completed a post-rotation exam. The mean number of structures correctly identified on the exams was compared for significant differences utilizing a paired t-test. RESULTS: Residents were able to identify significantly more anatomic structures on the post-rotation exam as compared with the pre-rotation exam (mean 14.1 vs. 9.9, P<.001), as well as more peripheral nerve targets. The most frequently misidentified structures on the pre-rotation exam were the subclavian vein, the sciatic nerve in the popliteal fossa, and the femur. CONCLUSIONS: Ultrasound-naive anesthesiology residents, who received instruction and experience with ultrasound-guided peripheral nerve blocks on a 4-week regional anesthesia rotation, significantly improved their ability to independently identify relevant anatomic structures with ultrasonography.